Researchers gave some people with diabetes who struggle to afford food a $65 monthly voucher to buy healthy groceries. After 6 months, people who got the vouchers ate significantly more fruits and vegetables and felt more food secure. However, the vouchers didn’t actually lower their blood sugar levels (measured by HbA1c tests) as much as researchers hoped. The study included 390 people in Toronto with diabetes and food insecurity, and shows that while food vouchers help people eat better, controlling diabetes may require additional support beyond just making healthy food more affordable.

The Quick Take

  • What they studied: Does giving people with diabetes money to buy healthy food help them control their blood sugar better?
  • Who participated: 390 adults (average age 60) with diabetes and food insecurity in Toronto. About half were men and half were women, with diverse backgrounds including Black, South Asian, and White participants.
  • Key finding: The voucher program didn’t significantly lower blood sugar levels (HbA1c dropped by only 0.18%, which wasn’t statistically meaningful). However, people who got vouchers ate twice as many vegetables and fruits daily compared to the control group.
  • What it means for you: Food vouchers are helpful for eating healthier and reducing food stress, but they alone may not be enough to control diabetes. People with diabetes likely need additional support like medication, exercise, or nutrition counseling alongside improved food access.

The Research Details

This was a randomized controlled trial, which is one of the strongest types of research. Researchers randomly divided 390 people into two groups: one group received a $65 monthly voucher (or $85 for larger families) for 6 months to buy healthy foods at grocery stores, while the other group continued with their normal access to food. The researchers measured blood sugar control, vegetable and fruit intake, food security, and overall health at the beginning and end of the study.

The study took place at 7 different locations in Toronto from March 2023 to April 2025. Participants had to have diabetes with blood sugar levels in a certain range and had to be experiencing food insecurity (struggling to afford enough food). This design allowed researchers to see if the voucher itself caused changes, rather than other factors.

This research approach is important because it shows cause-and-effect relationships. By randomly assigning people to groups, researchers could be confident that any differences between groups were due to the voucher program, not other factors. The study also measured both what people reported eating and actual blood markers, which helps verify whether self-reported improvements were real.

This study has several strengths: it was published in a highly respected medical journal (JAMA Internal Medicine), it used random assignment to reduce bias, and it included diverse participants. However, the study only lasted 6 months, so we don’t know if benefits would continue longer. Also, people self-reported their food intake, which can be less accurate than direct measurement. The study was conducted in Canada, so results may differ in other countries with different food systems.

What the Results Show

The main finding was that the $65 monthly voucher did not significantly lower blood sugar levels (HbA1c) compared to the control group. The difference was only 0.18%, which is too small to be considered meaningful or statistically significant. This was surprising because researchers expected that better access to healthy food would improve blood sugar control.

However, the voucher did have clear positive effects on eating habits. People who received vouchers were much more likely to eat vegetables 2 or more times per day (45% versus 22% in the control group) and fruits 2 or more times per day (43% versus 23%). This shows the voucher successfully encouraged healthier eating patterns.

The voucher also improved food security—meaning people felt less worried about having enough food to eat. Additionally, people who received vouchers reported better overall health compared to those without vouchers. These improvements in daily life quality are important, even though blood sugar control didn’t improve as much as hoped.

Interestingly, while people reported eating more vegetables and fruits, their actual nutrient levels (measured through blood tests for beta-carotene and vitamin C) didn’t change significantly. This suggests people may have been eating more vegetables and fruits, but perhaps not in large enough quantities or with enough variety to change their blood nutrient levels. The voucher also didn’t improve financial security overall, suggesting that a $65 monthly voucher helps with food specifically but doesn’t address broader money problems.

This study adds important information to existing research. Previous studies have shown that food insecurity (not having enough money for food) is linked to worse diabetes control. This research confirms that improving food access is valuable, but it also reveals that access alone may not be sufficient. Other research suggests that diabetes control depends on multiple factors including medication, physical activity, stress management, and education—not just food availability.

Several limitations should be considered: The study only lasted 6 months, so we don’t know if benefits would continue or improve with more time. People self-reported how much they ate, which can be inaccurate. The study was done in Toronto, Canada, so results might differ in other locations with different food systems or healthcare. The voucher amount ($65-85 monthly) may not be enough to make a major difference in blood sugar control. Finally, we don’t know if participants also received other diabetes care like medication or counseling, which could affect results.

The Bottom Line

Food vouchers appear to be a helpful tool for people with diabetes who struggle to afford food. They should be considered as part of a broader diabetes management plan that includes medication, regular exercise, and healthcare provider support. The evidence is moderate that vouchers alone will significantly improve blood sugar control, but they do improve eating habits and reduce food stress. People with diabetes should discuss with their doctor whether food assistance programs might help them.

This research is most relevant to people with diabetes who have difficulty affording healthy food. It’s also important for policymakers, healthcare systems, and community organizations considering food assistance programs. People with well-controlled diabetes or those without food insecurity may see different results. Healthcare providers should consider recommending food assistance programs as part of comprehensive diabetes care.

Based on this study, improvements in eating habits appeared within 6 months. However, blood sugar improvements may take longer than 6 months, or may require additional interventions beyond food access. People should expect to see changes in their diet and food security within weeks to months, but shouldn’t expect major blood sugar improvements from vouchers alone.

Want to Apply This Research?

  • Track daily vegetable and fruit servings (aim for 2+ servings each per day) and weekly food security feelings (rate 1-10 how worried you are about affording food). This captures the areas where the voucher showed benefits.
  • If using a food assistance voucher, use the app to plan weekly meals featuring vegetables and fruits, then track what you actually purchase and eat. Set reminders to use your voucher before it expires and log which healthy foods you buy.
  • Monitor blood sugar (HbA1c) every 3 months with your doctor while using food vouchers, and track eating patterns weekly in the app. Also monitor overall health feelings monthly. This helps identify if you need additional diabetes support beyond food access, such as medication adjustments or nutrition counseling.

This research shows that food vouchers help people eat more vegetables and fruits and reduce food stress, but don’t significantly lower blood sugar levels on their own. If you have diabetes, food vouchers should be part of a complete diabetes management plan that includes medication prescribed by your doctor, regular physical activity, and ongoing medical care. Do not change your diabetes medications or treatment based on this study without talking to your healthcare provider first. This information is educational and not a substitute for medical advice from your doctor.